Posted: September 26th, 2023

Nancy is a 59-year-old client who is grieving the loss of her 14-year-old Maltese

Psychiatric Nursing-SFD-GR01
. Overview

This assignment aims to deepen your understanding of mental health conditions, therapeutic interventions, and ethical considerations in mental health nursing. You will be provided with a case study featuring a patient with a mental health condition. Your task is to analyze the case and answer the corresponding question.

Case Scenario:

Nancy is a 59-year-old client who is grieving the loss of her 14-year-old Maltese dog that has recently died of congestive heart failure. Nancy has experienced fatigue, lack of energy, and mild depression. These symptoms have caused her to miss work. When her coworkers ask why she is feeling so tired, Nancy makes excuses by saying that she “just can’t seem to sleep well at night.” Nancy tells the nurse that she is reluctant to be honest with her colleagues because she thinks that they will not understand her overwhelming feelings of sadness and grief related to the death of her pet.

a. What is the cultural significance of Nancy’s fear of sharing her feelings with her colleagues?

b. Which term best describes the type of grief Nancy is experiencing?

Instructions

Read Thoroughly: Familiarize yourself with the case, noting key elements like symptoms, medical history, and social factors affecting the patient.

Research: Conduct scholarly research to better understand the condition presented in the case study. Use at least five peer-reviewed articles to support your analysis.

Ethical Considerations: Examine any ethical considerations associated with the case. For example, consider patient consent, confidentiality, and duty of care.

Reflection: Write a 300-word reflection on what you have learned from this assignment and how it will impact your future practice.

Academic Integrity

Plagiarism will not be tolerated. Ensure that all sources are correctly cited and that you have not copied material from other sources unless appropriately cited.

Cultural significance of Nancy’s fear:
Nancy comes from a culture where emotions are often kept private from colleagues. Showing vulnerability is seen as a sign of weakness. Her reluctance to openly grieve the loss of her pet dog stems from not wanting to appear emotionally fragile at work (Kleinman, 2004).
Type of grief Nancy is experiencing:
The grief Nancy describes experiencing fits the criteria for uncomplicated or normal grief. This involves feelings of sadness, loneliness, and distress following a significant loss like the death of a beloved pet. With time and social support, her symptoms should gradually resolve (Maciejewski et al., 2016).
Therapeutic interventions:
Some supportive interventions for Nancy could include active listening, normalization of her grief experience, and encouragement to join a pet loss support group. This allows sharing feelings and memories in a non-judgmental setting. Cognitive behavioral therapy techniques like challenging irrational thoughts and behavioral activation may also help her process the loss and regain normal functioning (Shear et al., 2016).
Medication may be considered if her symptoms persist or intensify beyond 6 months. However, the initial approach should focus on psychosocial support given the relatively uncomplicated nature of her grief currently (Prigerson et al., 2009).
Ethical considerations:
Nancy’s right to privacy must be respected regarding her disclosure of feelings to colleagues. The nurse should provide a compassionate, non-judgmental presence and avoid pressuring Nancy to share more than she feels comfortable with. If her symptoms worsen or she expresses suicidal thoughts, appropriate intervention and referral would be ethically required (Canadian Nurses Association, 2017).
Reflection: This case highlights how culturally-influenced views about emotional expression can impact a person’s willingness to seek help for common mental health issues like grief. As nurses, we must be sensitive to such sociocultural factors affecting our patients. I have learned the importance of creating a safe, stigma-free environment for processing difficult emotions. This experience will help me provide more empathetic, culturally-competent care to diverse clients in the future.
References:
Canadian Nurses Association. (2017). Code of ethics for registered nurses. Ottawa: Author.
Kleinman, A. (2004). Culture and depression. New England Journal of Medicine, 351(10), 951–953. https://doi.org/10.1056/NEJMp048078
Maciejewski, P. K., Maercker, A., Boelen, P. A., & Prigerson, H. G. (2016). “Prolonged grief disorder” and “persistent complex bereavement disorder”, but not “complicated grief”, are one and the same diagnostic entity: an analysis of data from the Yale Bereavement Study. World Psychiatry, 15(3), 266–275. https://doi.org/10.1002/wps.20354

Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., Raphael, B., Marwit, S. J., Wortman, C., Neimeyer, R. A., Bonanno, G., Block, S. D., Kissane, D., Boelen, P., Maercker, A., Litz, B. T., Johnson, J. G., First, M. B., & Maciejewski, P. K. (2009). Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS medicine, 6(8), e1000121. https://doi.org/10.1371/journal.pmed.1000121
Shear, M. K., Reynolds, C. F., Simon, N. M., Zisook, S., Wang, Y., Mauro, C., Duan, N., Lebowitz, B., Schoenbaum, M., Dolan-Sewell, R., Iosifescu, D., & Clayton, P. (2016). Optimizing Treatment of Complicated Grief: A Randomized Clinical Trial. JAMA psychiatry, 73(7), 685–694. https://doi.org/10.1001/jamapsychiatry.2016.0892

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